Phrenic nerve damage may occur as a complication of specific surgical procedures, prolonged mechanical ventilation, or physical trauma. The consequent diaphragmatic paralysis or dysfunction can lead to major complications. To elucidate the role of the non-diaphragmatic respiratory muscles during partial or complete diaphragm paralysis induced by unilateral and bilateral phrenic nerve damage at different levels of ventilatory pressure support in an animal model. Ten pigs were instrumented, the phrenic nerve exposed from the neck and spontaneous respiration preserved at three levels of pressure support: high, low and null at baseline condition, after left phrenic nerve damage and bilateral phrenic nerve damage. Breathing pattern, thoraco-abdominal volumes and asynchrony and pressures were measured at each condition. Physiological breathing was predominantly diaphragmatic, homogeneously distributed between right and left sides. After unilateral damage, the paralyzed hemidiaphragm was passively dragged by the ipsilateral ribcage muscles and the contralateral hemidiaphragm. After bilateral damage, the drive to and the work of breathing of ribcage and abdominal muscles increased, to compensate for diaphragmatic paralysis, ensuing paradoxical thoraco-abdominal breathing. Increasing level of pressure support ventilation replaces this muscle group compensation. When the diaphragm is paralyzed (unilaterally and/or bilaterally), there is a coordinated reorganization of non-diaphragmatic respiratory muscles as compensation that might be obscured by high level of pressure support ventilation. Non-invasive thoraco-abdominal volume and asynchrony assessment could be useful in phrenic nerve injured patients to estimate the extent and type of inspiratory muscle dysfunction.

中文翻译：

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respiratory神经损伤猪模型中呼吸肌作用下的生理变化和补偿机制

specific神经损伤可能是由于特定的外科手术，长时间的机械通气或身体创伤引起的并发症。随之而来的diaphragm肌麻痹或功能障碍可导致重大并发症。阐明在动物模型中不同水平的通气压力支持下单侧和双侧and神经损伤引起的部分或完全complete肌麻痹期间非the肌呼吸肌的作用。测试了十只猪，,神经从颈部暴露，自发呼吸在三个水平的压力支持下得以保持：基线状态下高，低和无效，左left神经损伤和双侧神经损伤。在每种情况下均测量呼吸模式，胸腹体积以及异步和压力。生理呼吸主要是横diaphragm膜，在左右两侧之间均匀分布。单侧损伤后，瘫痪的上ph肌被同侧胸腔肌和对侧上ph肌被动牵拉。在双侧受损后，胸腔和腹肌的驱动力和呼吸作用增加，以补偿diaphragm肌麻痹，从而导致胸腹呼吸自相矛盾。压力支持通气水平的提高取代了这种肌肉群的补偿。当the肌瘫痪（单侧和/或双侧）时，非-肌呼吸肌的协调重组可能被高水平的压力支持通气所掩盖。